ADDICTION TAKES A TERRIBLE TOLL ON THE CITY

Take a walk through the Tenderloin, the Inner Mission, the Haight
Ashbury or Bayview-Hunters Point and you will see the ravages of drug
addiction up close. It is not a pretty picture. You will see men, women
and even children whose lives slowly are being wasted.

What you won't see are the hidden costs of addiction. Treating abcesses
caused by injection drug use alone costs $18 million per year. Imagine
the other health costs --- emergency-room care at $1,200 a visit, 400
monthly visits for heroin, cocaine and methamphetamine. Then imagine yet
more costs --- the law-enforcement costs associated with policing
dangerous street and turf wars, the cleanup of waste by the Department
of Public Works, the loss of tax revenue from businesses and workers
affected by the epidemic, the loss of a productive, educated, trained
workforce.

Estimates of San Franciscans who abuse or are addicted to narcotics are
in the range of 2 percent to 10 percent. Many of these are recreational
users, and the effects of narcotic use have not yet been noticed by
friends, family or co-workers.

And we are not talking about marijuana or aspirin here, but drugs such
as crack cocaine, heroin and methamphetamine.

The addiction problem in the homeless community is especially acute.
Look at any of the estimates of the number of homeless on our streets
5,000 (the Mayor's Office), 14,000 (the Coalition on Homelessness)
or 12,000 (the Department of Public Health). Then use the 40 percent
marker that the department uses in estimating the percentage of homeless
with addictions, and we can see that anywhere from 2,000 to 5,600
homeless persons are addicted.

The most successful of all treatment models for severe addiction is
inpatient or long-term residential.

After all, how can we expect a person who is homeless and addicted to go
to outpatient treatment one to three times a week?

The City funds 506 residential beds --- the total capacity is 1,100 beds
when we add programs not funded by The City. Using the lowest of the
three estimates of homeless addicted, we come up short by about 1,500
beds.

One of the goals of the Drug Abuse Board this year is to have The City
find funding for an additional 1,000 beds to be used for the needs that
are there --- detox programs, family programs (often addiction is a
family affair) and programs that serve the comprehensive needs of the
addicted patient.

The suffering and abject misery we can lessen and the savings we can
realize would be significant. All of the providers whom I have spoken
with about this proposal are supportive of 1,000 new
residential-treatment beds. All that is missing is the money.

Californians spoke loudly at the ballot box by voting resoundingly last
November for Proposition 36, the Substance Abuse and Crime Prevention
Act of 2000. The 61 percent margin reflects the growing sentiment that
addiction is a disease, a medical condition. Today and tomorrow, April
27 and 28, the San Francisco Drug Abuse Advisory Board Public Policy
Committee will host a town hall meeting at City Hall in room 263
focusing on public comment, information, criticism, and suggestions on
what The City is doing right, what it needs to change or improve in the
treatment programs it funds, how to increase funding (currently less
than 1 percent of the city budget) and what policies should be in place
as The City moves forward in recognizing that we face an epidemic whose
costs both financially and in lives is almost beyond comprehension.

Everyone in San Francisco has a stake in this. Please come and speak out
today from 1 p.m. to 3 p.m. and tomorrow from noon to 2 p.m.. We want to
hear from you.